Non-Hodgkin Lymphoma | Age 83 | R/R

Fit 83-year old patient with a history of SLL (CD5 positive, lambda restricted), stage 3A non-bulky, treated with six cycles of bendamustine and rituximab in 2016. They now have a cervical lymph node biopsy showing DLBCL (CD5 negative, lambda restricted). PET-CT shows stage 1A bulky disease. Do you consider this Richter's transformation? What treatment would you recommend for this patient?

GU Cancer | Age 74 | New Dx

74 yo M with extensive comorbid conditions and a new diagnosis of Stage IIIA bladder cancer with left hydronephrosis and hematuria. Underwent TURBT given presentation with gross hematuria. Found to have invasive high grade papillary urothelial carcnoma invading muscularis propria Question: is this someone you would recommend/offer systemic treatment for given his comorbidities?

Lung Cancer | Age 63 | R/R

Patient with metastatic lung adenocarcinoma (EGFR exon 19 del) who is now progressing radiographically with new adrenal met. Liquid NGS shows an EGFR C797N mutation. In review of literature it is not clear if this is an acquired osimertinib resistance mutation (like C797S). Would you switch therapy at this time?

Classical Hematology | Age 70

70 year old female on apixaban for atrial fibrillation (5mg bid) and no arterial or venous thrombosis history who has just been diagnosed with PV. What is your practice on thrombosis prophylaxis in patients that are anticoagulated already? Do you add aspirin?

Lung Cancer | Age 81 | New Dx

81yo man with stage IIIB RLL adenocarcinoma. The mass is 11.5 cm. Radiation oncology wants me to shrink it before they attempt radiation, so I would plan to treat him as unresectable/advanced/metastatic with carbo/pem/pem. However, due to the carbo shortage I need to find an alternative. Any other recommendations for systemic therapy?

Classical Hematology | Age 40 | New Dx

Middle age female on long term apixaban for DVT in 2017. She has been stable without evidence of recurrence. She is admitted in 2023 with bacteremia. Has a femoral PICC in place for antibiotic access and a week later develops catheter associated femoral vein DVT. How do you manage her new PICC associate DVT?